Although falls are more prevalent as ageing proceeds, it cannot be assumed that they happen due to ageing alone. The retrospective cohort study of data was targeted to make an analysis of prevalence of falls in anaemic patients in comparison to the non-anaemic elderly admitted to the acute geriatric department and evaluation of pertinent influence of age, gender and immobility on occurrence of falls. During the considered period of four years (2012-2016) the authors treated 9 363 elderly patients aged 79,9±8,6 years (in the majority of them 65+ years). Among them there were 8 809 non-anaemic and subgroup of 551 old anaemic patients (aged 81±7 years) with decreased haemoglobin (<110 g/l). Falls at hospital admission in average was present in 1 766 non-anaemic persons (20%) in comparison to 380 falls among anaemic patients (68,6%). Prevalence in anaemic subgroup is statistically significant higher (p<0,005). Also relation between falls and age, ADL and MMSE test and mobility is highly statistically significant (p<0,001). Meaningfully higher is occurrence of repeated falls in the anaemic subgroup in comparison to the non-anaemic one (41,2 vs 1,7%). The occurrence of falls in female gender in comparison to men is statistically significant higher in non-anaemic patients, not in anaemic group. Authors emphasize that anaemia appears to us as significant risk factor for falls in the elderly.

Хотя падения чаще случаются в пожилом возрасте, нельзя предположить, что они происходят только из-за старения. Ретроспективное когортное исследование данных было нацелено на анализ распространенности падений у пациентов с анемией по сравнению с неанемичными пожилыми людьми, поступившими в отделение неотложной гериатрии, и оценку соответствующего влияния возраста, пола и неподвижности на случаи падений. За рассматриваемый четырехлетний период (2012–2016 гг.) были обследованы 9 363 пожилых пациента в возрасте 79,9±8,6 года (большинство из них 65+ лет). Из них были 8 809 неанемичных пациентов и подгруппа из 551 пожилого пациента с анемией (в возрасте 81±7 лет) со сниженным гемоглобином (<110 г/л). Падение при госпитализации в среднем наблюдали у 1 766 неанемичных лиц (20%) по сравнению с 380 падениями у анемичных пациентов (68,6%). Распространенность падений в анемичной подгруппе статистически значимо выше (р<0,005). Кроме того, связь между падением и возрастом, ADL и MMSE тестом и мобильностью статистически значима (р<0,001). Значительно выше была встречаемость повторных падений в анемичной подгруппе по сравнению с неанемичной (41,2% против 1,7%). Частота падений у женщин по сравнению с мужчинами статистически значимо выше у неанемичных пациентов. Авторы подчеркивают, что анемия представляется нам значительным фактором риска падений у пожилых людей.

• Klíčová slova
• anaemia of chronich diseases, anaemia, falls, multi-morbidity, old age,
• MeSH
• anemie komplikace   MeSH
• hospitalizace * MeSH
• lidé MeSH
• prevalence MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• úrazy pádem statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

THEORY: The prevention of patient falls is one of the safety goals set forth by the Ministry of Health of the Czech Republic. GOAL: A sociological survey was carried out to (1) determine to what extent nurses identify the risk of patient falls at admission, (2) if the risk is reassessed and at what intervals, (3) what preventive measures were taken, and (4) in what way are patient falls reported. METHODOLOGY: A representative sample consisting of general nurses working shifts on inpatient wards at hospitals in the Czech Republic was surveyed. Altogether 772 nurses took part in the study. RESULTS: The survey showed that at admission, most nurses assessed the risk of falls (91.6%). Nonetheless, it should stand as a stark warning that nearly one fifth of the respondents (16.2%) did not reassess the risk of falls after admission! On the other hand, it can be perceived as a positive that most nurses (70.1%) use a multifaceted program of preventive measures for at risk patients and immediately reported fall events to the doctor in charge (71.4%). During statistical testing, the predication that a working atmosphere supporting a culture of patient safety would significantly decrease the probability of patient falls and increases the willingness of nurses to use preventive programs in daily practice. CONCLUSION: Results from the survey showed that a system to minimalize fall risks has been successfully introduced into the hospitals of the Czech Republic. The system is based on the recommendations of the Ministry of Health of the Czech Republic.

• MeSH
• bezpečnost pacientů normy   MeSH
• dospělí MeSH
• hospitalizovaní pacienti * MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemocnice normy   MeSH
• personál sesterský nemocniční * MeSH
• průzkumy zdravotní péče MeSH
• úrazy pádem prevence a kontrola   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

INTRODUCTION: Hospitals strive, over the long term, to reduce the incidence of falls of hospitalized patients. Falls are monitored, analyzed, and regularly evaluated and corrective and preventive actions are established based on the findings. To establish preventive actions, it is essential to determine the circumstances under which the patient fell and in what type of health care facility. OBJECTIVES: The goal of the study consisted in retrospectively analyzing falls in selected hospitals of the South Bohemian Region in 2014 and 2015. METHODS: Our retrospective analysis of 1101 patient falls was reported by the health care staff from 4 hospitals of the South Bohemian Region. The data from the reported incidents (i.e., falls) from individual hospitals were encoded and entered in a database using the SASD statistical program and subsequently subjected to statistical analysis. RESULTS: The highest frequency of falls was found on internal wards, 565 (51.3%) with the second highest frequency found on subsequent care wards, 267 (24.3%). The study showed that the risk of falls increases with patient age; more than 60% the hospitals, in the monitored period, involved patients over 70 years of age. Falls occurred most frequently in patient rooms and in bathrooms. Statistically significant relationships were identified between the type of ward and the time of the fall, between the type of the ward and the location of the fall, between patient age and the time of the fall, between patient age and the location of the fall, between the time of fall and the location of fall, and between the location of fall and the patient mobility before the fall. CONCLUSION: Intensive monitoring of patient falls and the circumstances under which the falls occurred are needed to fully understand the epidemiology of hospital falls.

• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemocnice statistika a číselné údaje   MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• úrazy pádem statistika a číselné údaje   MeSH
• věkové faktory MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

PURPOSE: The main purpose of the study was to establish a gait speed cut-off value to predict foot pain and the risk of falls among community-dwelling older adults. PATIENTS AND METHODS: In this cross-sectional study, one-hundred and twenty White older women speaking Croatian (mean ± SD age 71.02 ± 6.78 years, height 161.77 ± 6.23 cm, weight 70.29 ± 12.97 kg, body mass index 26.79 ± 4.42 kg/m2) were recruited. The prevalence of foot pain was assessed by a single-item question and the risk of falls by the Downtown Fall Risk Index with a proposed cut-off value of "low risk" (<3 points) vs "high risk" (≥3 points) of falls. Self-selected gait speed (the independent variable) was estimated with a pressure platform (Zebris Company, Munich, Germany). RESULTS: Mean gait speed was 0.95 m/s. Of the total sample, 53.30% and 33.30% reported foot pain and had higher risk of falls. For foot pain and the risk of falls, gait speed cut-off values were 0.88 m/s and 0.85 m/s (area under the curve = 0.80 and 0.83, standard error = 0.043 and 0.043, p < 0.001). Sensitivity for foot pain and the risk of falls was 66.20% and 85.90% and specificity was 84.80% and 69.00%. Slower gait speed was associated with higher prevalence of foot pain (OR = 10.92, 95% CI 4.28 to 27.89, p < 0.001) and higher risk of falls (OR = 13.59, 95% CI 5.45 to 33.87, p < 0.001). CONCLUSION: Proposed gait speed values of 0.88 m/s and 0.85 m/s may be used in clinical settings to predict foot pain and the risk of falls among community-dwelling older women.

• Klíčová slova
• discomfort, elderly, falls, risk, velocity,
• MeSH
• artralgie diagnóza   MeSH
• chůze (způsob) fyziologie   MeSH
• index tělesné hmotnosti MeSH
• lidé MeSH
• noha (od hlezna dolů) MeSH
• průřezové studie MeSH
• rizikové faktory MeSH
• rychlost chůze * MeSH
• samostatný způsob života MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• úrazy pádem prevence a kontrola   MeSH
• Check Tag
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Chorvatsko MeSH

Patient falls represent a significant burden on healthcare facilities, particularly by prolonging hospitalization and increasing the cost of subsequent healthcare. In most cases, fall is caused by a combination of several modifiable and unmodifiable risk factors. The pharmacotherapy, which is often unreasonably administered in relation to patient health condition and drug combination, belongs among the modifiable risk factors. In this case report, the potential effect of pharmacotherapy on the patient fall-related risk as well as clinical pharmacy service that can contribute to reducing the risk of falls by engaging of clinical pharmacist in a multidisciplinary team with focus on the risks of pharmacotherapy and their management are shown.

• Klíčová slova
• clinical pharmacist, fall, fall risk increasing drugs (FRIDs),
• MeSH
• farmaceuti * MeSH
• farmakoterapie MeSH
• hospitalizace MeSH
• lidé MeSH
• rizikové faktory MeSH
• senioři MeSH
• úrazy pádem prevence a kontrola   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

PURPOSE: We aimed to outline the existing information and the underlying mechanisms of risk of falls associated with the use of urinary antimuscarinics for overactive bladder (OAB) or alpha-blockers for benign prostatic hyperplasia (BPH) in older adults. In addition, we aimed to provide assistance to clinicians in decision-making about (de-)prescribing these drugs in older adults. METHODOLOGY: Based on a literature search in PubMed and Google Scholar, we reviewed the literature, and identified additional relevant articles from reference lists, with an emphasis on the most commonly prescribed drugs in OAB and BPH in older patients. We discussed the use of bladder antimuscarinics and alpha-blockers, their potential side effects related to falls, and the deprescribing of these drugs in older adults. RESULTS: Urinary urgency or incontinence and lower urinary tract symptoms due to untreated OAB and BPH contribute to fall risk. On the other hand, the use of bladder antimuscarinics and alpha-blockers is also related to fall risk. They contribute to (or cause) falling through dizziness, somnolence, visual impairment, and orthostatic hypotension while they differ in their side-effect profiles regarding these problems. Falls are common and can cause a remarkable amount of morbidity and mortality. Thus, preventive measures should be taken to lower the risk. If the clinical condition allows, withdrawal of bladder antimuscarinics and alpha-blockers is recommended in fall-prone older adults. There are practical resources and algorithms that guide and assist clinicians in deprescribing these drug groups. CONCLUSIONS: The decision to prescribe or deprescribe these treatments in patients at high risk of falls should be individualized. In addition to explicit tools that are helpful for clinical decision-making in (de-)prescribing these drugs, STOPPFall (a recently developed expert-based decision aid specifically aiming to prevent falls) is present to assist prescribers in attaining decisions.

• Klíčová slova
• Alpha-blockers, Antimuscarinics, Benign prostatic hyperplasia, FRIDs, Falls, Overactive bladder, Urinary incontinence,
• MeSH
• alfa blokátory škodlivé účinky   MeSH
• antagonisté muskarinových receptorů škodlivé účinky   MeSH
• hyperaktivní močový měchýř * farmakoterapie   komplikace   MeSH
• hyperplazie prostaty * farmakoterapie   komplikace   MeSH
• lidé MeSH
• senioři MeSH
• symptomy dolních močových cest * komplikace   farmakoterapie   MeSH
• úrazy pádem prevence a kontrola   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• alfa blokátory MeSH
• antagonisté muskarinových receptorů MeSH

The incidence of falls of older people is increasing. Falls are the most common cause of injuries of older adults. Costs for the treatment of injuries caused by falls are constantly increasing too. In fragile and polymorbid individuals, falls are most often of multifactorial ethiology; age-related frailty, coinciding chronic diseases and interactions with the external environment. The most serious consequences of falls include hip fractures and intracranial injury. The American Geriatric Society recommends an annual falls and instability screening in people 65 years of age. Multifactorial interventions should be targeted primarily at people with two or more falls or with a history of injury after a fall and at high-risk patients. It includes treatment of diseases that increase the risk of falls, management of podiatric problems, correction of visual deficit, optimization of medication, use of compensatory aids, home environment adaptation and education of older people and their family members. Vitamin D supplementation is recommended for indicated patients. Recently published reports, however, are reserved for its fall reduction effect. The results of rehabilitation studies are not consistent, with the best effect being reported in special programs for older adults. Using 3D technologies to simulate virtual reality can represent a new approach to improve patient adherence to physical activity. Key words: falls - multifactorial intervention - older people - prevention - risk factors - screening.

• Klíčová slova
• falls - multifactorial intervention - older people - prevention - risk factors - screening,
• MeSH
• adherence pacienta MeSH
• cvičení * MeSH
• lidé MeSH
• morbidita MeSH
• rizikové faktory MeSH
• senioři MeSH
• úrazy pádem * prevence a kontrola   statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH

THEORY: Patients falls have a multifactorial character and typically have multiple causalities. GOAL: The goal of the study was to identify risk factors for falls of hospitalized patients. METHODOLOGY: This was a case-control study. The study included 222 patients who experienced a fall during their hospitalization (cases) and 1,076 patients who did not fall during their hospitalization (controls). The study involved four hospitals in the South Bohemian Region of the Czech Republic. The study took place during the 2017 calendar year. RESULTS: The average age of patients who experienced a fall was 77.9 years. The group of cases included 5-times more patients with a history of falls than the controls. Patients who fell were in higher risk of falls than patients in the control group at hospital admission. The group of cases also had a higher prevalence of confused and restless patients; however, the group did not include a statistically significantly higher number of incontinent patients, patients with eating and drinking disorders, or patients with intravenous therapy than the control group. CONCLUSION: Interventions aimed at prevention of falls should be included in care plans, especially for older patients, patients who have fallen in the past, patients who have movement restriction, patients with cognitive dysfunction, and patients with increased need of assistance with basic daily activities.

• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• nemocnice statistika a číselné údaje   MeSH
• prevalence MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• studie případů a kontrol MeSH
• úrazy pádem statistika a číselné údaje   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

Although previous evidence has shown that deviated foot structure and function are associated with falls, little is known of the association between foot rotations and falls in apparently healthy older adults. Therefore, the main purpose of the study was to determine the associations between foot rotation and falls. In this cross-sectional study, we recruited 120 older women (mean±SD; age 71.01±6.77 years; height 158.92±21.41 cm; weight 70.29±12.97 kg; body-mass index 26.79±4.42 kg/m2). Foot rotations were assessed by using pressure platform (Zebris manufacturer, Munich, Germany), while the risk of falls was assessed by using Downtown Fall Risk Index questionnaire. Correlations and multiple regression models were applied to calculate the associations. In unadjusted model, higher foot rotation was associated with higher risk of falls (β = 0.14, p<0.001 for both feet). In a model adjusted for age, body-mass index, foot pain and fitness index, higher foot rotation remained associated with higher risk of falls (β = 0.10, p<0.001 for both feet). Our study shows that older adults with higher foot rotation are at higher risk of falls. Special interventions aiming to correct for deviated foot function in older women are warranted.

• MeSH
• bolest patofyziologie   MeSH
• index tělesné hmotnosti MeSH
• lidé MeSH
• noha (od hlezna dolů) patofyziologie   MeSH
• průřezové studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• sexuální faktory MeSH
• úrazy pádem * MeSH
• věkové faktory MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Stair descent is one of the most common forms of daily locomotion and concurrently one of the most challenging and hazardous daily activities performed by older adults. Thus, sufficient attention should be devoted to this locomotion and to the factors that affect it. This study investigates gender and age-related differences in balance control during and after stair descent on a foam mat. Forty-seven older adults (70% women) and 38 young adults (58% women) performed a descent from one step onto a foam mat. Anteroposterior (AP) and mediolateral (ML) centre of pressure velocity (CoP) and standard deviation of the CoP sway were investigated during stair descent and restabilization. A two-way analysis of variance (ANOVA) revealed the main effects of age for the first 5 s of restabilization. Older women exhibited significantly higher values of CoP sway and velocity in both directions compared to the younger individuals (CoP SDAP5, 55%; CoP SDML5, 30%; CoP VAP5, 106%; CoP VML5, 75%). Men achieved significantly higher values of CoP sway and velocity only in the AP direction compared to their younger counterparts (CoP SDAP5, 50% and CoP VAP5, 79%). These findings suggest that with advancing age, men are at higher risk of forward falls, whereas women are at higher risk of forward and sideways falls.

• MeSH
• chůze (způsob) fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lokomoce fyziologie   MeSH
• mladý dospělý MeSH
• posturální rovnováha fyziologie   MeSH
• senioři MeSH
• sexuální faktory MeSH
• úrazy pádem * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH